I am currently going through the process to have lapband. Starting my 6 month supervised diet this week. Done my sleep apnea, stress test, pulminary function test, and a few more. Waiting for results. I have aetna NAP choice POS II. I want to make sure since i am spending all of this money for these test and supervised diets (around $ 800) that i have every thing that aetna needs to approve me for the surgery. The only thing that i worry about is the proof of being 40+ bmi for 5 years, even though i have. There were a few years in between that i didn't go to the doctor (not even the female doctor ) so i not for sure if i can come up with these records. So i would just like to here anyones experience with aetna good or bad. I really want this surgery so information would be very appreciated and helpful.

I just started with Aetna 1/1/08 and the band is covered. I just have to go through a 12 week weight loss program. I wish there was a way I didn't have to go through that, but I have patients. I've done every diet in the book.

Does anyone know what the weight loss program consists of? My first appointment with Dr. Nutricianist is 1/17/08.

Thanks!

:whoo:Soon to be banded, Kim

Well I have Aetna PPO and it took them only 1 week to approve me!!

They approved you right away,or after your 3 month plan?

It took 6 months from seminar to final approval/surgery. I had to do the psych evaluation which consisted of making sure I had support at home and understood what I was getting into. Also had to have a 3 month supervised dietician study, also a joke!! After that I was denied because I hadn't sent proof of 5 years of obesity issues. Called my ob/gyn, chiropractor, and general practitioner and had them fax the paperwork to the office and about a month later was approved! I remember how long it seemed at the time and thought it would never end. It will end and all will be good....just keep with it and don't give up! Wish you all well, I'm sure you won't be disappointed in the end!!

kimillionaire - I also have Aetna. I finish my 12 week supervised diet in 18 days. Lots of people have to do 6 months, so be very grateful for the 12 week requirement! The diet you choose is up to you and your doctor. Then you keep a food and exercise diary and check in to be weighed once a month. I also had to do a psyc eval., one visit to make sure I understood what I am getting into, and two appts. with a nutritionist (one in the beginning, and one next week). You also must provide 5 years of weight history. Records from a doctor's office, any office that documented your weight when you went in for the appt. You must also fall into their BMI requirements. I have tried to follow the criteria and complete everything they required. It remains to be seen if I will get approval. It seems very hard to predict what they will do. Paperwork to be submitted to them on Jan. 21st. Then the wait begins.

Good luck to you on your journey, and I wish success to you are getting your approval.

It will be a high protein low fat diet. I had to do the psych evaluation, 3 month weight loss/nutritionist. Also, keep track of exercise and food intake. I was really worried about it, did real well the first month, lost 9 lbs., maintained the second month, and gained 2 lbs. for the third month. I was worried Aetna would kick it out because of that. They didn't and I got approval the week before Christmas. What a wonderful Christmas present. I have my first appt. with Dr. Marsden for pre-op on January 10. Hopefully will be banded in late January or early February.

SKCULPEPPER-I was so glad to read your post about the 3 month diet. I lost 7lbs. the first month, 3 the second month, but not sure I am doing so hot this last month. I have been worried about Aetna with regards to that, so I am happy to see they didn't hold it against you. Thanks for the post. I also have chosen to use Dr. Marsden. Can I ask you where Aetna approved you to have the surgery done? I don't see the surgery facility I have been attending on my list of in network, although Dr. Marsden certainly is on my list of in network surgeons. Good luck to you and keep us posted on how you do.

Okay, I was finally submitted to Aetna today. I'm calling them on Monday for a status haha. I wanna get this done! :confused: Wish me luck with the approval drones!

kimillionaire - I also have Aetna. I finish my 12 week supervised diet in 18 days. Lots of people have to do 6 months, so be very grateful for the 12 week requirement! The diet you choose is up to you and your doctor. Then you keep a food and exercise diary and check in to be weighed once a month. I also had to do a psyc eval., one visit to make sure I understood what I am getting into, and two appts. with a nutritionist (one in the beginning, and one next week). You also must provide 5 years of weight history. Records from a doctor's office, any office that documented your weight when you went in for the appt. You must also fall into their BMI requirements. I have tried to follow the criteria and complete everything they required. It remains to be seen if I will get approval. It seems very hard to predict what they will do. Paperwork to be submitted to them on Jan. 21st. Then the wait begins.

Good luck to you on your journey, and I wish success to you are getting your approval.

Thanks alot! Your post really helped me understand the process. I'm very excited!!!!

Okay, I was finally submitted to Aetna today. I'm calling them on Monday for a status haha. I wanna get this done! :confused: Wish me luck with the approval drones! :mad:

Sending you good vibes!!! Please keep us posted on how it goes!!!

:ranger: Kim

It took 6 months from seminar to final approval/surgery. I had to do the psych evaluation which consisted of making sure I had support at home and understood what I was getting into. Also had to have a 3 month supervised dietician study, also a joke!! After that I was denied because I hadn't sent proof of 5 years of obesity issues. Called my ob/gyn, chiropractor, and general practitioner and had them fax the paperwork to the office and about a month later was approved! I remember how long it seemed at the time and thought it would never end. It will end and all will be good....just keep with it and don't give up! Wish you all well, I'm sure you won't be disappointed in the end!!

With the 12 week dietician study, what isAetna looking for? Substantial weight loss or what? Will they deny you if you lose a lot of weight? What's the deal?

:Dafter six long weeks of waiting, I finally got approved. My husband on the other hand didn't because he only had three years of weight history. does anyone have any suggestions with regards to what we can do for his appeal?:help:

:Dafter six long weeks of waiting, I finally got approved. My husband on the other hand didn't because he only had three years of weight history. does anyone have any suggestions with regards to what we can do for his appeal?:help:

do you have anything? a visit to the ER or a walk-in clinic? That may have his weight on it. Also, if you have previous records that shows his weight issue that's older, that may help. Maybe a letter from his physician would help as well.

I called Aetna today - they have my stuff - they said it was in pending status but I have a surgery date listed of 1/21/2008 (that's gonna hafta change, lol) but he's checking as to why it says its pending when everything appears to be in order...

I found out the Aetna has gotten worse this year. They want you to have five years in a row weight history. I think that sucks!!!! However I did find out I went to one Acute Care on 1/13/04 so that might just save me! I start my 3month diet on Wednesday morning.

I have my 3rd apt out of 4 with the "3 month" physician on the 25th... and my 90 days is over end of next month. I did my sleep apnea overnigth testing over the weekend... and am getting my medical records together, although I do not have 5 years in a row, I have 12 years of being pretty grossly overweight. So we'll see- its going to come down to whoever reviews my file and if Im denied Ill appeal it. Hope everyone else keeps chuggin along as well!